Individual provider Active NPI

Justin Michael Tinsley, DC

  • Neurology Chiropractor
  • Kennesaw, GA
National Provider Identifier
1164744058
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CHIR008556 Issued in GA
Practice address
440 Ernest Barrett Parkway
Suite 58
Kennesaw, GA 30144
Phone
(770) 795-0453
Fax
(770) 795-0454
NPI assigned
Feb 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CHIR008556 GA Primary

Addresses

Primary practice location

440 Ernest Barrett Parkway
Suite 58
Kennesaw, GA 30144

Mailing address

440 Ernest Barrett Parkway
Suite 58
Kennesaw, GA 30144
Phone (770) 795-0453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000115 GA Practitioner - Chiropractic 6709066723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2710 Town Ctr Dr NW
Kennesaw, GA 30144
Phone (770) 795-0453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008556GAMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Check Foundation LLC Neurology CurrentSince Jul 5, 2010 Accepting new patients

Locations

2255 Old 41 Hwy NW
Ste 110
Kennesaw, GA 30144

2710 Town Center Dr NW
Ste 104
Kennesaw, GA 30144
Phone (770) 795-0453

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1164744058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 ERNEST BARRETT PARKWAY",
            "address_2": "SUITE 58",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30144",
            "telephone_number": "770-795-0453",
            "fax_number": "770-795-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 ERNEST BARRETT PARKWAY",
            "address_2": "SUITE 58",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30144",
            "telephone_number": "770-795-0453",
            "fax_number": "770-795-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINSLEY",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-19",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "GA",
            "license": "CHIR008556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.